Minister Kathleen Lynch Opens The Sonas aPc Conference, Ireland

Kathleen Lynch, T.D., Minister of State with responsibility for Older People, today (May 26th 2011), officially opened the third Annual Sonas aPc Conference. The title of the Conference is Living with Dementia: Activity for Meaningful Lives There were over 300 delegates at the gathering which was addressed by a range of national and international experts on innovative new methods of enhancing the lives of those suffering from dementia.

Sonas aPc provides training for those who care for older people with dementia or intellectual disabilities. The training enables them to carry out therapeutic communication activities. The aim of Sonas is to activate each individual's potential for communication whatever that potential might be.

Minister Lynch also presented awards to three nursing homes who had achieved excellence in implementing the Sonas programme. These were St John's Community Hospital, Enniscorthy, St Joseph's Cluny, and Marymount Care Centre, Lucan.

Speaking at the conference Minister Lynch said; "Sonas is constantly championing new and innovative therapies, to ensure that people with dementia continue to live their lives to the full. To our worthy winners I am happy to say that these awards recognise your commitment to the Sonas philosophy and I offer you my warmest congratulations."

The Minister added; "The Government is aware of the challenges that Alzheimers and dementia will pose for us. The programme for Government commits us to developing a national strategy by 2013. This will support the delivery of long-term care services having regard to future demographic development and the resulting increase in demand for long-term care. The policy will be developed on the basis of the best evidence available from national and international sources".

Source:
Department of Health and Children, Ireland

Large Outbreak Of Haemolytic Uraemic Syndrome Caused By E. Coli In Germany - Important Advice For Travellers

The Health Protection Agency (HPA) is aware that Germany is currently experiencing a large outbreak of haemolytic uraemic syndrome (HUS), which is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that requires hospitalisation. Since the second week of May, there have been reports of approximately 214 cases of HUS and two people are reported to have died.

The outbreak is mainly affecting adults - almost 70 per cent of who are female. The cases are occurring mainly in northern Germany, but there are also reports from southern and eastern Germany.

This strain of VTEC infection suspected in this outbreak is O104 which is a rare strain of the infection and seldom seen in the UK.

England has so far seen two cases in German nationals with compatible symptoms. Other European countries have also seen cases of HUS and bloody diarrhoea among returning travellers.

The German authorities believe that a food source of infection is likely, and, early studies implicate raw tomatoes, cucumbers and lettuce. Although it is not clear whether one or more of these food items are associated with the outbreak, as a precaution they are advising people in Germany against eating raw tomatoes, cucumbers and lettuce, especially in the north of the country, until further notice.

The HPA and the National Travel Health Network and Centre (NaTHNaC) advises anyone travelling to Germany to follow the advice from the German authorities. In addition, returning travellers with illness including bloody diarrhoea should seek urgent medical attention and make sure they mention any recent travel history.

The public health organisation in Germany investigating the outbreak also recommend following the standard food and water hygiene advice.

Dr Dilys Morgan, head of the gastrointestinal, emerging and zoonotic infections department at the HPA, said: "The HPA is actively monitoring the situation very carefully and liaising with the authorities in Germany, the European Centre for Disease Control (ECDC) and the World Health Organization (WHO) as to the cause of the outbreak.

"We are keeping a close watch for potential cases reported in England and are working with colleagues in the devolved administrations to recommend they do the same. In addition we are in the process of alerting health professionals to the situation and advising them to urgently investigate potential cases with a travel history to Germany."

The HPA is also working closely with the Department of Health and the Food Standards Agency. The FSA is monitoring the situation closely and if there are any implications for food distributed in the UK they will provide an update.

Notes

1. In this outbreak many more people are suspected to have bloody diarrhoea, which can be serious, or milder forms of the infection which are usually self limiting and clears within seven days. The public health organisation investigating the outbreak in Germany is the Robert Koch Institute.

miss out, book now! - Agoda.com/Hotels

2. Haemolytic Uraemic Syndrome (HUS) is a serious complication from verocytotoxin-producing E. coli (VTEC) infection that affects the blood, kidneys and in severe cases, the central nervous system. It is a serious illness that requires treatment in hospital and can be fatal.

3. The number of severe cases of HUS in a short period is very unusual and the affected age groups in this outbreak are not typical - HUS is a more common complication from E. coli infection in children.

4. Escherichia coli (commonly referred to as E coli) bacteria usually cause diarrhoea which settles within seven days without treatment. There are many strains of the infection. Occasionally, serious kidney and blood complications can occur, such as HUS.

5. Most people normally carry harmless strains of E. coli in their intestine. Both the harmless strains and the strains that cause diarrhoea are acquired primarily through ingestion of contaminated food or water. Person-to-person and animal-to-human transmission is through the oral-faecal route.

6. Good hygiene is very important in preventing person-to person spread and small children should be supervised with hand washing after using the toilet and before eating.

7. Verocytotoxin- producing E. coli (VTEC) O104 is a rare serogroup and further testing of samples is needed to confirm this as the cause of the outbreak. Reports from Germany refer to the VTEC cases as cases of Shiga-toxin producing E. coli (STEC). VTEC is also sometimes called Entrohaemorrhagic E. coli (EHEC).

8. Healthcare professionals and members of the public can find more information about travel health (including country specific advice) by logging onto the National Travel Health Network and Centre (NaTHNaC) website.

Source:
Health Protection Agency

New Clues To How Humble Painkiller Stifles Cancer Growth

Cancer Research UK scientists have shed light on how a common class of painkillers - which includes ibuprofen - may interact with a key protein that fuels the growth of many different types of cancer, according to a study published in the journal Chemical Communications today (Thursday).

Ibuprofen is one of several profens - a particular group of non-steroidal anti-inflammatory drugs (NSAIDs) - being investigated for their ability to prevent cancer.

The University of Bath research team* carried out an analysis of drugs in the same class as ibuprofen and discovered that they are all processed by the body in exactly the same way - through a protein called AMACR, which converts the drug into its active form.

AMACR is overactive in almost all prostate cancers, some bowel cancers and several other types of cancer and is thought to fuel the growth of the disease by boosting the cell's energy supply.

So understanding how drugs like ibuprofen might alter AMACR activity could help scientists better understand how they are able to block cancer growth.

Lead author Dr Matthew Lloyd, said: "Our study is the first to test other drugs in the same family as ibuprofen systematically and show that they're all processed by the same protein in the body. Some early laboratory studies have suggested that high doses of ibuprofen can halt the growth of prostate cancer cells, but the reasons for this aren't well understood.

"Understanding more about how this protein is acting in cells and what molecules it interacts with could provide important clues to how this process works, hopefully opening up new avenues of research for treating prostate cancer in the future."

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: "This research is part of an international effort to understand how drugs like ibuprofen could prevent, or slow down, the development of cancer. But there are risks as well as benefits and long term use of these drugs can have side effects, such as bleeding and stomach ulcers. Understanding more about how these drugs work on a molecular level is a crucial step in being able to develop better targeted drugs with fewer side effects in future."

References

Woodman et al., Chiral inversion of 2-arylpropional-CoA esters by human alpha-methyylacyl-CoA racemase 1A (P504S) - a potential mechanism for the anti-cancer effects of ibuprofen (2011), Chemical Communications, DOI: 10.1039/ClCC10763A.

Source:
Cancer Research UK

Most Authoritative Report On Colorectal Cancer And Diet Ever Conducted: Links With Meat, Fiber Confirmed

The most comprehensive and authoritative report on colorectal cancer risk ever published has concluded that red and processed meat increase risk of the disease and found that the evidence that foods containing fiber offer protection against colorectal cancer has become stronger.


"This report shows that colorectal cancer is one of the most preventable cancers," said Elisa Bandera, MD, PhD, who served on the World Cancer Research Fund/American Institute for Cancer Research's Continuous Update Project (CUP) Expert Panel that authored the report. "AICR has estimated that about 45 percent of colorectal cancer cases could be prevented if we all ate more fiber-rich plant foods and less meat, drank less alcohol, moved more and stayed lean. That's over 64,000 cases in the US every year."


The report, released today as part of WCRF/AICR's groundbreaking Continuous Update Project, has examined the links between colorectal cancer risk and diet, physical activity and weight, and updated the colorectal cancer findings of the charity's 2007 Expert Report.


A systematic review of the evidence was carried out by WCRF/AICR-funded scientists at Imperial College London, who added 263 new papers on colorectal cancer to the 749 that had been analyzed as part of the 2007 Report. An independent CUP Expert Panel then analyzed the totality of evidence and made new judgments.


Meat Link Remains Convincing


For red and processed meat, findings from 10 new cohort studies were added to the 14 included in the 2007 Report. The CUP Expert Panel concluded that there is convincing evidence that both red and processed meat increase colorectal cancer risk.


AICR recommends that people limit consumption to 18 ounces (cooked weight) of red meat a week - roughly the equivalent of five or six small portions of beef, lamb or pork - and avoid processed meat. (The report showed that ounce for ounce, consuming processed meat increases risk twice as much as consuming red meat.)


Evidence of Fiber's Protective Role Upgraded


The CUP Expert Panel also concluded that the evidence showing that foods containing dietary fiber reduce colorectal cancer risk has become stronger since the publication of the 2007 report. They considered the evidence sufficient to strengthen the conclusion that foods containing fiber are protective from "probable" to "convincing".


The analysis for fiber added seven more studies to the existing eight from the 2007 Report; the CUP Expert Panel noted that the evidence has become much more consistent.


This reaffirms AICR's recommendation for people to eat a plant-based diet, including foods containing fiber, such as whole grains, fruits, vegetables and beans.


Evidence on Activity, Body Weight, Alcohol Still ConvincingThe experts concluded that studies published since 2007 added to the evidence that maintaining a healthy weight and being physically active are both convincingly linked to lowering colon cancer risk, while a healthy weight is linked to lower rectal cancer risk. The CUP Expert Panel also affirmed that carrying excess fat especially around the waist is a convincing cause of colorectal cancer. There is also convincing evidence that alcohol consumption increases colorectal cancer risk in men and it also probably increases risk in women.

Dr. Alan Jackson, Chair of the WCRF/AICR CUP Expert Panel, said: "Our review has found strong evidence that many cases of colorectal cancer are not inevitable and that people can significantly reduce their risk by making changes to their diet and lifestyle.

"Because our judgments are based on more evidence than ever before, the public can be confident that this represents the best advice available on preventing colorectal cancer.

"There has been a lot of debate over the last few years about the strength of evidence that red and processed meat increase risk of cancer. We hope our review can help give clarity to those people who are still confused about the strength of the evidence.

"On meat, the clear message that comes out of our report is that red and processed meat increase risk of colorectal cancer and that people who want to reduce their risk should consider cutting down the amount they eat."

CUP Expert Panel member Dr. Elisa Bandera added: "Many people feel confused about cancer prevention because it can seem like a new study is published every week that suggests something either causes or prevents cancer.

"But the CUP takes the latest scientific findings and adds them to the existing body of evidence in a systematic way that ensures our advice takes the latest research into account. This means people can be confident that AICR's recommendations represent the most up-to-date, evidence-based information on cancer prevention available."

Notes

-- The CUP report on colorectal cancer contains the judgments of the WCRF/AICR Continuous Update Project Expert Panel. It is chaired by Dr. Alan Jackson of the University of Southampton and the other members are: Dr. Elisa Bandera of the Cancer Institute of New Jersey; Dr. Stephen Hursting of the University of Texas; Dr. David Hunter of Harvard University; Dr. Anne McTiernan of the Fred Hutchinson Cancer Research Center; Dr. Hilary J Powers of the University of Sheffield; Dr. Ricardo Uauy of Instituto de Nutricion y Tecnologia de los Alimentos in Chile and the London School of Hygiene and Tropical Medicine; and Dr. Steven H Zeisel of the University of North Carolina. Dr. Arthur Schatzkin, of the National Cancer Institute, served on the CUP Expert Panel until his death in 2010. Professor Elio Riboli of Imperial College London is a panel observer, Dr. John Milner of the National Cancer Institute is an advisor.

-- The CUP Expert Panel made judgments on the strength of the evidence following a systematic review of the evidence by a team of scientists at Imperial College London led by Dr Teresa Norat.

-- The CUP central database is a unique and valuable resource for researchers. Once WCRF/AICR updates the evidence on all cancers, the CUP database will be made accessible to the world's scientific community.

-- The full WCRF/AICR CUP Expert Panel report.

-- The timing of the CUP Expert Panel report's publication coincides with the publication in the journal PLoS One of the Imperial College team's systematic review of the evidence on red and processed meat and colorectal cancer.

-- Following an analysis of the Imperial College team's report, the CUP Expert Panel concluded that there is convincing evidence that red meat; processed meat; excess body fat; and abdominal fatness (fat carried around the waist) increase risk of colorectal cancer.

-- The CUP Expert Panel concluded there is convincing evidence that regular physical activity reduces risk of colorectal cancer. They also concluded that foods containing dietary fiber, such as fruits, vegetables, whole grains and beans, reduce risk of colorectal cancer. The panel also judged that garlic probably reduces risk of colorectal cancer.

-- The CUP Expert Panel concluded that there is convincing evidence that alcohol increases colorectal cancer risk in men. For women, it probably increases risk.

-- The CUP Expert Panel judged that milk probably reduces colorectal cancer risk, but AICR does not make a recommendation regarding dairy foods because the evidence for overall cancer risk remains unclear.

-- The evidence also shows that dietary supplements containing calcium probably reduce colorectal cancer risk, but when this finding is weighed against the totality of evidence on diet and cancer, AICR still recommends looking to whole foods to get the nutrients we need, instead of relying on supplements for cancer protection.

-- Red meat refers to beef, pork and lamb. If a person eats 3.5 ounces of red meat every day (24.5 ounces per week), their risk of colorectal cancer will be 17% higher than someone who eats no red meat. If they eat 7.0 ounces of red meat every day (49 ounces per week), their risk will be 34% higher, and so on. The evidence shows that there is very little increase in risk for people who keep their intake of red meat to less than 18 ounces per week

-- Processed meat is meat preserved by smoking, curing, salting, or by the addition of preservatives. Examples include ham, bacon, pastrami and salami, as well as hot dogs and sausages. If a person eats 3.5 ounces of processed meat every day (24.5 ounces per week), their risk of colorectal cancer will be 36% higher than someone who eats no processed meat. If they eat 7.0 ounces of processed meat every day (49 ounces per week), their risk will be 72% higher.

-- There are set criteria that the evidence must meet for the CUP Expert Panel to be judged "convincing." The evidence must be robust enough for it to be thought highly unlikely to be modified in the foreseeable future as new evidence accumulates. All the following are also generally required:

-- Evidence from more than one study type;

- No substantial unexplained heterogeneity within or between study types or in different populations relating to the presence or absence of an association, or direction of effect;

- Good quality studies to exclude with confidence the possibility that the observed association results from random or systematic error, including confounding, measurement error, and selection bias;

- Presence of a plausible biological gradient ('dose response') in the association. Such a gradient need not be linear or even in the same direction across the different levels of exposure, so long as this can be explained plausibly;

- Strong and plausible experimental evidence, either from human studies or relevant animal models, that typical human exposures can lead to relevant cancer outcomes.

Source:
American Institute for Cancer Research (AICR)

$5M For Researchers To Fight Superbugs, Australia

A new treatment for 'superbugs' could be developed in Australia after a University of Queensland researcher received $5 million in funding to modify an existing antibiotic.

Professor Matthew Cooper, from UQ's Institute for Molecular Bioscience (IMB), will use the Seeding Drug Discovery Award from the UK's Wellcome Trust to chemically alter the structure of vancomycin.

"Vancomycin and similar antibiotics were traditionally only used as a last-ditch treatment against bacterial infections, when all else had failed," Professor Cooper said.

"But with bacteria becoming resistant to other treatments, these 'drugs of last resort' are now in common use," he said.

"However, many bacteria are now resistant to even these treatments. In fact, they're multi-resistant, with genes that enable them to survive the administration of several different types of antibiotics.

"These bacteria are known as 'superbugs' and they're an increasing problem in communities and hospital wards around the world."

In 2010, infectious diseases killed more people than cancer, according to figures from the World Health Organisation's Global Health Observatory Database.

While deaths are rising, the number of new antibiotics to treat these infections has declined to a quarter of those launched in the 1980s.

"If new treatments aren't developed, there is a real danger that diseases, which are easily treated now, will prove fatal in the future, and the world will regress to a situation akin to the pre-antibiotics era, when more than half of all deaths were from bacterial infection," Professor Cooper said.

Professor Cooper, along with Professor David Paterson from the UQ Centre for Clinical Research and Dr Jason Roberts from the Royal Brisbane Hospital, will modify vancomycin into a new drug that weakens the structures in bacteria that cause resistance.

"Early laboratory tests on the test compounds have been very promising and with this support from the Wellcome Trust we hope to identify lead compounds to take forward into preclinical testing," said Professor Cooper, who performed the original research at the University of Cambridge in collaboration with a UK-based biotechnology company.

In a recent commentary in top scientific journal, Nature, Professor Cooper called for governments to enact legislation to make it more attractive for companies to develop antibiotics, to help overcome the problem of resistance.

"Antibiotic resistance is a global health crisis. It requires global action before one of the most valuable discoveries of the 20th century is lost to the 21st century," he said.

Notes

Professor Cooper joined the IMB in 2009 after receiving a $4 million Australia Fellowship to conduct research into novel antibiotics to combat drug-resistant pathogens. He is an internationally recognised expert in the field of diagnostic device and biosensor development.

Source:
The Wellcome Trust
The Institute for Molecular Bioscience
University of Queensland

Surge In Parents Taking Kids With Common Medical Problems To Emergency Care, UK

The number of children taken to emergency care departments with common medical problems has risen sharply over the past decade, reveals a study published online in Emergency Medicine Journal.

During the past 10 years, the way that the NHS provides care at night and at weekends for common medical problems has changed.

The family doctor is no longer responsible for providing that care and advice to worried parents, with large private companies now generally contracted to provide this instead.

Researchers looked at the medical records of children under the age of 15 who had attended the emergency department at Queen's Medical Centre in Nottingham between February 2007 and February 2008. These findings were compared with information about attendees a decade earlier.

During the 10 years, the number of patients attending the children's emergency department had remained similar, but the number attending with common medical problems had risen by 42%.

A total of 39,394 children were seen in 2007-8 of whom 14,724 had medical problems. This compared with 38,982 children seen overall in 1997 of whom 10,369 had medical problems .

Ten common medical problems accounted for 85% of the most visits, including breathing difficulty, fever, diarrhoea with or without vomiting, rash and cough.

The proportions of patients attending for each of these conditions were similar in 1997 and 2007-8, except for breathing difficulties.

"Over a 10-year period, attendances to the paediatric emergency department have remained similar; however, there has been a disproportionate rise in the number attending with medical conditions. The presenting problems also remain similar, although there has been a significant reduction in those presenting with difficulty in breathing," write the authors.

"Care pathways focusing on this limited range of high-volume presenting problems will make the maximum impact on improving quality and value of care for children," they add.

Source
Emergency Medicine Journal

Texas RNs Condemn Retaliation Against Brownsville Nurses For Protesting Unsafe ICU Conditions

Texas registered nurses today condemned a Brownsville, Texas hospital for the firings of seven highly skilled critical care nurses for challenging unsafe staffing for the facility's most vulnerable patients in the hospital's intensive care unit (ICU).

The unwarranted terminations, which deprive patients of nurses with more than 70 years of irreplaceable experience, occurred at Valley Regional Medical Center, an affiliate of Hospital Corporation of America, the largest for-profit hospital corporation in the world. The RNs are members of National Nurses Organizing Committee-Texas, the state's largest RN union and an affiliate of National Nurses United, the nation's biggest RN union and professional association.

Nurses from Valley Regional and from other Texas HCA-affiliated hospitals will conduct a picket and press conference in front of Valley Regional on Tuesday.

What: Protest picket and press conference
When: Tuesday, May 24, 11:30 a.m. to 12:30 p.m.
Where: Valley Regional Medical Center, 100 E. Alton Gloor Blvd., Brownsville

All seven ICU nurses serve as code team nurses and four of the seven are open heart nurses. The staffing shortage in the ICU is now being filled by 13 temporary agency nurses who do not share the lost RNs' history in the facility or with the patients at the hospital.

The nurses were targeted for refusing to accept an additional assignment that in their professional judgment was unsafe and a violation of the Texas Nursing Practice Act.

Hospital management has demanded the nurses, who in the ICU provide constant care for the hospital's most severely ill patients, take on additional duties of temporary charge nurse, who make clinical assignments for patients and staff on the floor, and code team assignments, which can require them to rush to other hospital floors to assist with patients - leaving their own ICU patients and their ICU charge duties behind.

We have been asking the hospital to correct this unsafe situation for some time, with no result," said Ramiro Castillo, RN. "Because of our increasing concern for the safety of our critically ill patients, we felt we no longer had a choice but to refuse the additional duties that put our patients at risk."

"As a registered nurse, my full commitment is to my patients," said Cleo Vasquez, RN. "I have a responsibility under my license to ensure the safety of my patients. I'm disappointed with hospital leadership for not living up to these same standards--standards that they claim to hold."

"Instead of being fired, these nurses should be honored and held up as examples of true patient advocates," said Laura Dominguez, an ICU RN who works elsewhere in Brownsville and is an NNOC-Texas leader.

Additionally, the RNs blasted the cavalier attitude of the hospital's chief nursing officer for gushing in an e-mail that the threatened firings, which would exacerbate the facility staffing crisis, were "groovy."

Source:
National Nurses United

Mechanism Behind Compound's Effects On Skin Inflammation And Cancer Progression Demonstrated By Researchers

Charles J. Dimitroff, MS, PhD, and colleagues in the Dimitroff Lab at Brigham and Women's Hospital, have developed a fluorinated analog of glucosamine, which, in a recent study, has been shown to block the synthesis of key carbohydrate structures linked to skin inflammation and cancer progression. These findings appear in a recent issue of the Journal of Biological Chemistry.

Dr. Dimitroff and colleagues show for the first time that the fluorinated glucosamine therapeutic works not through direct incorporation into growing sugar chains as previously believed but instead blocks the synthesis of a key sugar, UDP-GlcNAc, inside immune cells characteristically involved inflammation and anti-tumor immunity

Accordingly, this report underscores a novel and previously unknown mechanism by which fluorinated glucosamine analogs could shape and reduce inflammation intensity, while boosting anti-tumor immune responses. Such knowledge could prove valuable in the design of new and more potent glucosamine mimetics against disease as well as in treatment strategies to utilize existing glucosamine mimetics more efficiently.

This research was funded by grants from the National Cancer Institute and the National Center for Complementary and Alternative Medicine of the National Institutes of Health.

Source:
Holly Brown-Ayers
Brigham and Women's Hospital

Actelion's Novel CRTH2 Antagonist Meets Primary Endpoint In Phase II Study In Patients With Seasonal Allergic Rhinitis

Actelion Ltd (SIX: ATLN) today announced that a Phase II study with its novel orally-active CRTH2 antagonist in seasonal allergic rhinitis has met its primary endpoint with statistical significance (p<0.05).

The study assessed the efficacy and tolerability of various doses of this novel CRTH2 antagonist in adult patients with seasonal allergic rhinitis ("hay fever") due to mountain cedar pollen. Treatment in this study was well tolerated across all treatment groups and no serious adverse events were reported.

Jean-Paul Clozel, M.D. and Chief Executive Officer of Actelion commented: "We are very pleased with the results of this study since, for the first time, we now have proof that CRTH2 antagonists can bring clinically relevant benefit to patients suffering from allergic rhinitis. This study complements the positive proof-of-mechanism study in asthma reported in 2009. Together, these studies provide substantial information that will guide us in the further development of this compound and our follow-up molecules in allergic disorders."

Jean-Paul concluded: "We will now fully analyze the data and plan our next steps, taking into account the ongoing development program in asthma. We are very confident that, with these promising results, CRTH2 antagonists can play an important role in expanding Actelion's portfolio beyond specialty products."

Following full analysis of the study, results will be made available through scientific publication.

About the study design

The study was a prospective, multi-center, double-blind, placebo-controlled, active-reference, multiple-dose levels, randomized, parallel-group Phase II study. The study enrolled 579 patients, who were treated for two weeks, with the primary outcome measure to demonstrate efficacy versus placebo being the mean change from baseline in Daytime Nasal Symptom Score over the entire treatment period.

About Actelion's CRTH2 antagonist

Actelion's CRTH2 antagonist blocks some of the effects of prostaglandin D2 (PGD2) on inflammation and, as a consequence, the amplification and maintenance of allergic reactions. It targets allergic inflammation, with the potential of being used as therapy in both asthma and/or allergic rhinitis as well as in many other potential indications that are based on allergic inflammation.

Positive data have previously been obtained in a proof-of-mechanism study with Actelion's orally-active CRTH2 antagonist in mild-to-moderate allergic asthma. In the 18-patient 2-period crossover double-blind placebo-controlled study, the compound was well tolerated and demonstrates efficacy versus placebo on the primaryendpoint (FEV1) during the late allergic reaction (3-10 hours) after a bronchial allergen challenge.

A Phase II dose-finding study in asthma is currently enrolling and is expected to report results mid-2012.

Notes

About seasonal and perennial allergic rhinitis

Allergic rhinitis is an inflammation of the nasal passages, usually associated with watery nasal discharge, nasal obstruction, sneezing and itching of the nose. Ocular symptoms such as itching, conjunctival swelling and erythema, eyelid swelling, lower eyelid venous stasis are often associated.

Airborne allergens, both perennial and seasonal can cause allergic rhinitis manifestations. Most common among them, dust mites, cockroaches, moulds and animal dander, are examples of year-around allergens. Tree and grass pollens are primarily seasonal outdoor allergens. (Seasonal pollens depend on wind for cross-pollination.)

The impact of allergic rhinitis

Up to 20% of the population can develop allergic rhinitis.

Poorly controlled symptoms of allergic rhinitis may contribute to decreased health-related quality of life, including loss of sleep, secondary daytime fatigue, learning impairment, decreased cognitive functioning, and decreased long-term productivity.

Poorly controlled allergic rhinitis may be associated with the aggravation of, or a predisposal to, asthma.

The American Academy of Allergy, Asthma & Immunology task force on allergic disorders estimated that allergic rhinitis results in 3.5 million lost workdays and 2 million missed school days each year.

Source:
Actelion Ltd.

The Stroke Association Features In ITV Daybreak's 'Donate A Day' Initiative, UK

What could be more valuable than your time? Daybreak's 'Donate a Day' launches Monday 23 May.

The Stroke Association's celebrity ambassador Graham Cole is joining such names as Simon Cowell, Rod Stewart, Pixie Lott and Paul O'Grady who have all pledged their support to Daybreak's 'Donate a Day' initiative launching on Monday 23 May 2011.

The fully interactive initiative will encourage viewers young and old to pledge their time to help a worthy cause or those in need: from doing a neighbour's shopping, transforming a piece of waste ground, decorating a community centre to simply offering an elderly person some company.

As part of the initiative, viewers will see Adrian Chiles, Christine Bleakley and other members of the Daybreak presenting team donate their time over the course of the week for various causes.

Graham visited The Stroke Association's Communication Support Group in Camden last week to show his support for the campaign.

Adrian will return to Birmingham to spend the day with Age UK, Christine will visit the Teenage Cancer Trust in Cardiff, Dan will teach tennis to inner city kids, Kate will work in a Save the Children store and Dr Hilary will spend the day at a hospice in Exeter.

Stars of Emmerdale and Loose Women will also be donating their time across the week as part of the initiative.

As well as pledging to donate their time via http://www.itv.com/daybreak, viewers will be able to browse the online volunteers' gallery where there will find inspiration on how best they can donate their time.

Daybreak airs Monday-Friday, 6-8.30am, ITV1.

Source:
The Stroke Association

Cultured Men Are Happier And Healthier

Men who visit art galleries, museums, and the theatre regularly tend to enjoy better health and are more satisfied with life, reveals a study published online in the Journal of Epidemiology and Community Health.

The study found that both men and women who play musical instruments, paint or visit the theatre or museums felt in better health, enjoyed life more, and were less likely to be anxious or depressed then people who do not participate in cultural activities.

However, the effect was most pronounced in men who were interested in watching and looking at culture rather than doing creative or active cultural activities themselves.

The Norwegian researchers used questionnaires to determine how frequently 50,797 adults living in Nord-Trøndelag County participated in cultural activities and to assess their perceived state of health, satisfaction with life, and anxiety and depression levels.

All types of cultural activities were significantly associated with good health and satisfaction with life, and people who engaged in cultural activities had lower levels of anxiety and depression.

Moreover, the more culture was experienced, the greater were the benefits to health and wellbeing. The greatest benefits were seen in men who did "receptive" cultural activities, such as visiting theatres and museums.

"The results indicate that the use of cultural activities in health promotion and healthcare may be justified," comment the authors.

Source
The Journal of Epidemiology and Community Health

Bringing New Biomedical Technologies To Market: SBU Center For Biotechnology Launches Commercialization Fund

The Center for Biotechnology (CFB) at Stony Brook University has established the Biotechnology Commercialization Fund to accelerate the development of promising biomedical technologies emerging from Stony Brook University. Created with support from the New York State Foundation for Science, Technology, and Innovation (NYSTAR) and the Office of the Vice President for Research at Stony Brook University, the Fund will immediately help develop six technologies in partnership with researchers University-wide.

These projects, selected for support by an independent panel of industry and academic advisors, encompass a wide range of technologies with total funding reaching $456,000 for 2011. Overall, the projects center on the discovery of new diagnostics and therapeutics in areas such as musculoskeletal diseases, metabolic and cognitive disorders, cancer, burn injuries, inflammatory diseases, and other medical conditions.

"The establishment of the Biotechnology Commercialization Fund will be a catalyst to ensuring that groundbreaking biomedical research taking place at Stony Brook University advances with the ultimate goal to reach patients with better diagnostics and therapeutics," says Clinton T. Rubin, Ph.D., Distinguished Professor, Chair, Department of Biomedical Engineering, and Director, Center for Biotechnology.

Dr. Rubin expects that with New York State's emerging bioscience industry, the CFB's expertise in translating basic biomedical sciences into diagnostic and therapeutic technologies will continue to grow. He also says that the Fund will help build CFB's collaborative efforts with NYSTAR, Stony Brook University, and regional research institutions, to fuel biomedical research on a larger scale and enrich the economy of New York State.

Established in 1983, the CFB was one of the first university-based "proof of concept" centers in the country and has contributed to the development of more than a dozen commercially available products with cumulative sales exceeding $1 billion.

To learn more about the projects and the Bioscience Technology Commercialization Fund, go to the CFB's website at Centerforbiotechnlogy.org. Here is a summary of the first round of projects supported by the Fund:

New Cytokine and MMP Inhibitors: A Novel Class of Compound

The objective is the development of a series of compounds for the treatment of collagen-destructive and inflammatory diseases.

Investigators: Lorne M. Golub, D.M.D., MSc, M.D. (Honorary), Distinguished Professor, Oral Biology & Pathology, and Francis Johnson, Ph.D., Professor, Chemistry and Pharmacological Sciences

Treatment of Musculoskeletal, Metabolic and Cognitive Disorders through the Mechanical Control of Adult Stem Cell Fate

A non-drug strategy utilizing low intensity vibration (LIV) to restore and accelerate the recovery of the Adult Stem Cell progenitor population. Potential applications include diabetes, bone marrow disorders and cognitive dysfunction. The technology is already under development by Marodyne Medical for the treatment of osteoporosis.Investigator: Clinton T. Rubin, Ph.D., Distinguished Professor & Chair, Department of Biomedical Engineering

Microfluidics for Single Cell Genomics

A new single cell gene expression analysis allowing for a better understanding of the individual cellular components of different groups of cells (tumors, brain tissue, etc.) and how genes in individual cells play a role during stem cell differentiation. Such an approach could lead to methods for early cancer diagnostics and cancer treatment monitoring.

Investigators: Helmut Strey, Ph.D., Associate Professor of Biomedical Engineering, and Eric Brouzes, Ph.D., Research Assistant Professor of Biomedical Engineering,

A Lead Drug Molecule for the Treatment of Osteoporosis and Fractures The development of an algorithmically derived bioactive peptide for the treatment of osteoporosis and fractures.

Investigators: Srinivas Pentyala, Ph.D., Department of Anesthesiology; Michael Hadjiargyrou, Ph.D., Department of Biomedical Engineering, and David Komatsu, Ph.D., Department of Orthopedics

PLO-collagenase for Debridement of Partial Thickness Burn Injury

Burns which extend to the deep dermis require special medical treatment, since healing cannot occur until the denatured collagen is removed. This non-surgical agent for wound debridement has been shown to have increased performance levels over formulations currently on the market. Additional testing will be done in vivo.

Investigators: Marcia Simon, M.A., Ph.D., Professor and Director for Graduate Studies, Oral Biology & Pathology, and Harry S. Soroff, M.D., Professor Emeritus of Surgery

Manipulation of Microbiome for Axillary Odor

The objective of this project is to apply the established platform technology of manipulating bacterial populations to achieve therapeutic benefits in the development of natural personal care products. New formulations and delivery systems will be developed for commercial use.

Investgator: Israel Kleinberg, D.D.S., Ph.D., D.Sc., F.R.C.D (C), Distinguished Professor and Director, Division of Translational Oral Biology, Department of Oral Biology and Pathology.

Source:
Center for Biotechnology at Stony Brook University

The aldosterone antagonist eplerenone

(Inspra, Pfizer) significantly reduced the development of new onset atrial fibrillation and flutter (AFF) in patients with class 2 heart failure, concludes a sub-analysis of the EMPHASIS-HF trial, presented at the Heart Failure Congress 2011, organized by the Heart Failure Association of the European Society of Cardiology (ESC). The analysis, presented in Late Breaking Session 1, furthermore showed that the beneficial effects of eplerenone in reducing major CV events were similar in patients with and without AFF at the start of the study.

The Eplerenone in Mild Patients Hospitalization And Survival Study in Heart Failure study (EMPHASIS-HF) - presented first at the American Heart Association Meeting in 2010 and published simultaneously on-line in the New England Journal of Medicine showed that eplerenone in comparison to placebo produced a 37% reduction in the primary end point of the composite of death from cardiovascular causes or hospitalization for heart failure, a 24% reduction in cardiovascular death, and a 42% reduction in hospitalization for heart failure for patients with class 2 heart failure.

While previous studies had shown that aldosterone blockade delivered significant benefits in patients with class 3-4 heart failure (The RALES study) or in post MI patients with left ventricular dysfunction (The EPHESUS study), what had been unknown until EMPHASIS-HF was whether the benefits could be extended to the far larger population of patients with mild heart failure (class1-2). The RALES study used spironolactone, while the EPHESUS study used the newer, more selective eplerenone.

The EMPHASIS-HF trial - which involved 2737 patients from 278 centres with NYHA class 2 heart failure and ejection fractions of no more than 35% - set out to address the question of whether eplerenone was effective in patients with mild heart failure. Patients were randomized to receive eplerenone (25mg once daily, up titrated to 50 mg daily if required) or placebo in addition to recommended therapy. The trial was stopped after 21 months due to the significant benefits in the eplerenone group. In the current presentation, the investigators have re-analyzed the original data to explore the development of new onset atrial fibrillation or flutter (AFF) in patients who had no history of AFF at baseline. The study also set out to determine whether eplerenone worked as well in patients who already had AFF at baseline as those who did not.

Results at an average follow-up of two years showed that new onset AFF occurred in 25/911 (2.7%) of the patients in the group randomized to eplerenone versus 40/883 (4.5%) in the group randomized to placebo (hazard ratio (HR) 0.58 95% CI 0.35-0.96, p=0.034). The analysis also showed that the risk of cardiovascular (CV) death or hospital admission for worsening heart failure (the primary endpoint of the original study) was not significantly different in patients with and without AFF at baseline (P=0.33).Commenting on the results study presenter Karl Swedberg, from the University of Gothenburg, Sweden, said, "This latest analysis makes an even stronger case for the use of eplerenone in patients with mild heart failure because in addition to reducing mortality it also reduces the incidence of AF. AF is a condition which both increases morbidity and complicates the care of patients with heart failure."

Use of eplerenone in patients with mild heart failure, he added, will be considered for inclusion in the ESC guidelines when they are updated at the end of 2011.

Eplerenone

Eplerenone, which has been called a "cleaner, safer" version of spironolactone, is approved for hypertension and for use in addition to optimal medical therapy early after acute MI in patients with congestive heart failure (CHF), on the basis of the Eplerenone Post-AMI Heart Failure Efficacy and Survival Study (EPHESUS) study. It has, however, yet to be approved for patients with mild HF.

While eplerenone is available generically in the US, the drug is still under patent in Europe and Canada.

Reference:
Zannad F, McMurray JJV, Krum H, et al. Eplerenone in patients with systolic heart failure and mild symptoms. New Eng J Med 2011: 364:11-21.

Source:
Jacqueline Partarrieu
European Society of Cardiology press@escardio.org View drug information on Inspra.

Platform Developed To Monitor Hematopoietic Stem Cells

A Canadian research team has developed an automated microfluidic cell culture platform to monitor the growth, survival and responses of hundreds of hematopoietic stem cells (HSCs) at the single cell level.

This new tool allows scientists to study multiple temporally varying culture conditions simultaneously and to gain new insights on the growth factor requirements for HSC survival.

"The ability to perform massively parallel cultures of single non-adherent mammalian cells will provide new avenues to explore complex biological questions," says Véronique Lecault, lead author of the study and a PhD candidate in the UBC Dept. of Chemical and Biological Engineering.

"Our results will find use in broader applications such as drug development, clone selection and culture optimization," says Lecault.

The findings appear in the May 22 issue of the online journal Nature Methods. The study is a collaborative project between the laboratories of Asst. Prof. Carl Hansen, UBC Physics and Astronomy, Centre for High-Throughput Biology, Prof. James Piret, UBC Chemical and Biological Engineering, Michael Smith Laboratories, Prof. Connie Eaves, Terry Fox Laboratory, BC Cancer Agency, and Dr. Keith Humphries, Terry Fox Laboratory, BC Cancer Agency.

Lecault explains that HSCs are found mainly in adult bone marrow and have the astounding ability to sustain the continuous production of specialized blood cells.

These cells have major clinical implications, in particular for the treatment of cancer and blood-borne diseases, but the mechanisms regulating their division into stem cells (self-renewal) or more mature cells (differentiation) are not very well understood.

The heterogeneous nature of hematopoietic populations further complicates the study of these rare HSCs by hiding individual responses into average measurements. Single cell studies are therefore critical to elucidate these mechanisms but current techniques are labour intensive, require expensive reagents and provide limited flexibility to characterize cells or exchange culture conditions.

The team designed and fabricated microfluidic devices -- about the size of a matchbox -- containing 1,600 to 6,400 miniature culture chambers that can sustain robust cell growth, along with an automated time-lapse imaging system to track clones over multiple days as they expand from single cells.

"There are many challenges associated with the culture of suspension cells in nanolitre volumes including dehydration, nutrient limitations, and rapid variations if culture conditions are not well controlled," says Lecault.

The team was able to solve these problems by integrating an osmotic bath to block evaporation combined with a unique geometry that allows for automated medium exchange, immunostaining on live clones and cell recovery.

Source:
Véronique Lecault
University of British Columbia

Medical Students Have Substantial Exposure To Pharmaceutical Industry Marketing

Medical students are commonly exposed to pharmaceutical marketing in the USA. This exposure is considerable even during their preclinical studies. Researchers from the Harvard Medical School explain in the journal PLoS Medicine that students have positive attitudes to their contact with pharmaceutical companies - they tend not to think that their exposure might undermine their training and ability to subsequently do their job properly.

Study leaders, Kirsten Austad and Aaron S. Kesselheim believe that educational strategies for medical students regarding their relationship with the pharmaceutical industry should directly address commonly-help myths about the effects of targeted marketing.

They evaluated all published studies on pharmaceutical marketing targeted at medical students and gathered data from 9,850 students from 76 different medical schools.

The researchers wrote that the majority of medical students were involved in some form of interaction with drug companies. This contact grew with nearly 90% of clinical students receiving educational materials from the industry.

The majority of students felt it was OK to receive gifts from pharmaceutical companies. They cited financial hardship, plus the fact that most students studying other subjects also received and accepted presents, among their reasons to justify entitlement to such gifts.

Nearly two-thirds of the medical students said they were in no way influenced or affected by bias induced by interactions with sales reps, gifts or promotional materials. There was no consensus among them on whether doctor-industry interactions should be controlled by either the government or medical schools.

The authors believe that better education on doctor-industry relationships, as well as institutions pushing for reforms may help achieve an environment which is good for the student and medicine in general.

They authors added:"Given the potential for educational and institutional messages to be counteracted by the hidden curriculum, changes should be directed at faculty and residents who serve as role models for medical students."

They concluded:"These changes can help move medical education a step closer to two important goals: the cultivation of strong professional values, as well as the promotion of a respect for scientific principles and critical review of evidence that will later inform clinical decision-making and prescribing practices."

"Medical Students' Exposure to and Attitudes about the Pharmaceutical Industry: A Systematic Review"
Austad KE, Avorn J, Kesselheim AS (2011)
PLoS Med 8(5): e1001037. doi:10.1371/journal.pmed.1001037

Written by Christian Nordqvist

SUTENT(R) Receives U.S. FDA Approval For Advanced Pancreatic Neuroendocrine Tumors

Pfizer Inc. announced today that the U.S. Food and Drug Administration (FDA) has approved SUTENT® (sunitinib malate) as the first anti-VEGF therapy to treat progressive, well-differentiated pancreatic neuroendocrine tumors (NET) in patients with unresectable locally advanced or metastatic disease. Pancreatic NET is a rare cancer reported in two to four people per million annually worldwide.1,2

"We are delighted that SUTENT has been granted approval by the FDA as an effective treatment option for individuals with pancreatic NET. This approval represents the third disease indication for SUTENT, which was approved by the FDA in 2006 for treatment of patients with advanced kidney cancer and imatinib-resistant or intolerant gastrointestinal stromal tumor (GIST)," said Dr. Mace Rothenberg, senior vice president of Clinical Development and Medical Affairs, Pfizer Oncology Business Unit. "Pfizer is committed to improving the lives of those with cancer. This approval is good news for the physicians, patients and caregivers who have had limited treatment options for this rare and difficult-to-treat tumor."

The FDA approval is based on data from the SUN 1111 pivotal Phase 3 trial that demonstrated SUTENT provided a clinically significant improvement in progression-free survival (PFS) compared to placebo (10.2 versus 5.4 months, p=0.000146) in this patient population.3 Treatment with SUTENT also yielded a statistically significant improvement in tumor response, with an objective response rate (ORR) of 9.3 percent (95% CI: 3.2, 15.4, p=0.0066). No objective responses were observed with placebo. In addition, while overall survival (OS) was not mature at the time of final analysis, nine deaths were observed in patients enrolled in the SUTENT arm versus 21 deaths in patients enrolled in the placebo arm.3,4

"This approval is welcome news for physicians who have struggled to find a treatment option that shows a substantial clinical benefit in treating advanced pancreatic NET," said Dr. Eric Raymond, professor of medical oncology and head of University Department of Medical Oncology (Service Inter Hospitalier de Cancerologie) Bichat-Beaujon, Clichy, France and principal investigator of the SUN 1111 Phase 3 trial. "Pancreatic NET is a highly vascular tumor, and as the first anti-VEGF therapy approved for this disease, SUTENT represents a treatment that attacks a key component of tumor growth."

About the SUN 1111 Trial

SUN 1111 was a multicenter, international, randomized, double-blind, placebo-controlled Phase 3 study (n=171) evaluating single-agent SUTENT in patients with unresectable pancreatic NET, characterized by cancer that could not be surgically removed. The primary endpoint was PFS. Other endpoints included OS, ORR and safety. Use of somatostatin analogs were allowed in the study.3The approval of SUTENT in this patient population was based on FDA assessment of PFS observed in SUN 1111. Previously reported investigator-assessed data from the trial, published in the New England Journal of Medicine, showed SUTENT more than doubled median PFS compared with placebo (11.4 versus 5.5 months, p<0.0001), which was found to be consistent in a blinded, independent central review of scans from the study (12.6 versus 5.8 months, p=0.000015).4,5 In February 2009, the independent Data Monitoring Committee for the SUN 1111 trial recommended that randomization to the study be halted early in the interest of patient safety and based on the very strong likelihood that the study would meet its primary endpoint if continued to completion. This may have led to an overestimate of the magnitude of PFS effect.

SUTENT has been approved for advanced pancreatic NET in Europe and nine additional countries. SUTENT is also approved for both gastrointestinal stromal tumors (GIST) after disease progression on or intolerance to imatinib mesylate, and advanced renal cell carcinoma (RCC) in over 100 countries and has been studied in over 10,000 patients in clinical trials. To date, with more than five years of experience, more than 100,000 patients have been treated with SUTENT worldwide.

About Pancreatic Neuroendocrine Tumors (Pancreatic NET)

Pancreatic NET is different from pancreatic adenocarcinoma, which account for about 95 percent of all pancreatic cancers.6 Pancreatic NET is a member of a broad group of cancers called neuroendocrine tumors, which arise from hormone-producing cells of the body.7,8 While neuroendocrine tumors that develop in the pancreas are known as pancreatic NET, those that arise in other areas of the body, including the lungs and gastrointestinal tract, are known as carcinoids.7 Pancreatic NET, which are mostly well-differentiated,9 account for approximately 22-28 percent of all neuroendocrine tumors.10,11 Nearly 90 percent of patients with pancreatic NET are initially diagnosed with locally advanced or metastatic disease (cancer that has spread to other organs).12 For patients with pancreatic NET that has metastasized, prognosis is poor, with a survival of only 1-3 years,13 similar to that seen with metastatic breast cancer or metastatic colon cancer.14,15

About SUTENT(®) (sunitinib malate)

SUTENT is an oral multi-kinase inhibitor that works by blocking multiple molecular targets implicated in the growth, proliferation and spread of cancer. Two important SUTENT targets, vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR) are expressed by many types of solid tumors and are thought to play a crucial role in angiogenesis, the process by which tumors acquire blood vessels, oxygen and nutrients needed for growth. SUTENT also inhibits other targets important to tumor growth, including KIT, FLT3 and RET.

Important SUTENT(®) (sunitinib malate) Safety Information

Hepatotoxicity has been observed in clinical trials and post-marketing experience. This hepatotoxicity may be severe, and deaths have been reported. It is recommended to monitor liver function tests before initiation of treatment, during each cycle of treatment, and as clinically indicated. SUTENT should be interrupted for Grade 3 or 4 drug-related hepatic adverse events and discontinued if there is no resolution. SUTENT should not be restarted if patients subsequently experience severe changes in liver function tests or have other signs and symptoms of liver failure.

Women of child bearing age who are (or become) pregnant during therapy should be informed of the potential for fetal harm while on SUTENT.

Decreases in left ventricular ejection fraction (LVEF) to below the lower limit of normal (LLN) and cardiac failure, including death, have been observed. Patients with concomitant cardiac conditions should be carefully monitored for clinical signs and symptoms of congestive heart failure. Patients should be monitored for hypertension and treated as needed with standard antihypertensive therapy. Complete blood counts (CBCs) with platelet count and serum chemistries should be performed at the beginning of each treatment cycle for patients receiving treatment with SUTENT.

The most common adverse reactions in GIST, RCC and pancreatic NET clinical trials were diarrhea, fatigue, asthenia, nausea, mucositis/stomatitis, anorexia, vomiting, neutropenia, hypertension, dyspepsia, abdominal pain, constipation, rash, hand-foot syndrome, skin discoloration, hair color changes, altered taste and bleeding.

1 Ramage JK, Davies AHG, Ardill et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut. 2005;54:iv1-16

2 Halfdanarson TR, Rabe KG, Rubin J et al. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Ann Oncol. 2008;19:1727-33.

3 SUTENT [Package Insert]. New York, NY: Pfizer, Inc. 2011.

4 Raymond E, et al. Sunitinib Malate for the Treatment of Pancreatic Neuroendocrine Tumors. N Engl J Med 2011; 334: 501-13.

5 ASCO GI Abstract #249. Evaluation of Progression Free Survival by Blinded Independent Central Review in Patients With Progressive, Well-Differentiated Pancreatic Neuroendocrine Tumors Treated With Sunitinib or Placebo. E. Van Cutsem - Presenter. 8th Annual Gastrointestinal (GI) Cancers Symposium, San Francisco, CA, January 20-22, 2011.

6 American Cancer Society. What is cancer of the pancreas? Available here. Accessed March 1, 2011

7 National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology - Neuroendocrine Tumors. Version 1.2011: National Comprehensive Cancer Network, Inc.; 2011.

8 Cancer.net. Neuroendocrine Tumor. Available here. Accessed May 6, 2011.

9 Choi I, Estecio M, et al. Hypomethylation of LINE-1 and Alu in well-differentiated neuroendocrine tumors (pancreatic endocrine tumors and carcinoid tumors). Modern Pathology. 2007; 20:802-810.

10 Pape UF, Berndt U, Muller-Nordhorn J et al. Prognostic factors for long-term outcome in gastroenteropancreatic neuroendocrine tumors. Endocrine-Related Cancers; 15: 1083-97, 2008.

11 Ter-Minassian M, Frauenhoffer CS, Hooshmand SM et al. Prospective analysis of clinical outcomes and prognostic factors in patients with Neuroendocrine tumors (NETs). ASCO Meeting Abstracts; Jun 14; 4044, 2010.

12 Yao JC, Hassan M, Phan A, et al. One hundred years after "Carcinoid": epidemiology of and prognostic factors for Neuroendocrine tumors in 35,825 cases in the United States. J Clin ONcol; 26 (18): 3063-72, 2008.

13 Yao JC, et al. Population-based study of islet cell carcinoma. Ann Surg Oncol. 2007;14(12):3492-3500.

14 Pal SK, et al "Lack of survival benefit in metastatic breast cancer with newer chemotherapy agents: The City of Hope cancer experience" ASCO Breast 2008; Abstract 95.

15 Kopetz S, Chang G, et al. Improved Survival in Metastatic Colorectal Cancer is Associated With Adoption of Hepatic Resection and Improved Chemotherapy. J Clin Oncol. 2009; 7:3677-3683.

Source:
Pfizer Oncology View drug information on Sutent.